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Med School Letters of Recommendation (LORs) | The Ultimate Guide 2022

Jun 23, 2021

Letters of recommendation (LORs), also known as letters of evaluation or reference letters, are a huge part of your medical school applications. These letters serve as an opportunity for others to vouch for your future as a physician. Great reference letters give medical school admissions committees insight into who you are, what drives you, your character, and your potential to lead a successful career as a doctor.

Since letters of evaluation are so important for your medical school application, we put together a comprehensive guide that covers everything you need to know about them.

Table of contents: 

The different types of letters of recommendation (LORs) for medical school applications

You might be surprised to find out there are multiple types of letters of recommendation. Knowing the different types of letters and understanding their differences will help you ensure that the letters of recommendation you are collecting are worthwhile. 

The three main types of recommendation letters are: 

  1. Committee letters
  2. Individual letters
  3. Letter packets

We’ll discuss each of these letters in depth. 

Individual letters

Individual letters are the most common type of reference letter. They are written by a single author who has gotten to know you well. Common authors for individual letters of recommendation include professors, employers, volunteer directors, etc. Essentially, anyone who’s had a professional relationship with you during your premedical career can serve as an author for an individual letter of recommendation. 

When choosing who to seek individual recommendation letters from, consider the impact of his/her letter in your medical school application. For instance, if you want to emphasize your academic aptitude in your medical school application, consider asking a professor who evaluated your academic performance with a letter grade to write a letter for you.  

On the other hand, if you want to highlight your work ethic and your professional habits, such as your punctuality and cooperation, then consider requesting an individual letter of recommendation from a past employer. 

Although individual letters of recommendation can be from anyone, make sure you choose recommenders who know you in a professional setting. Do not ask friends for letters of recommendation! Although your friends know you well and ideally have great things to say about you, this would look very unprofessional to a medical school admissions committee. 

Committee letters

Committee letters of recommendation are professional packets constructed by your university’s premedical advising center. Usually, the premedical advisor at your institution oversees the completion of this type of letter. Committee letters can be written in two styles. The traditional committee letter is written by one committee on your behalf. More modern committee letters are compiled excerpts from individual letters. Each university has their own specific protocols for writing committee letters. 

One major advantage of getting a committee letter is the premedical advisor at your university is responsible for collecting responses from faculty. This removes your burden of chasing down professors for a letter of recommendation. Another advantage is that multiple faculty members contribute to the committee letter. This shows medical schools you have many credible sources that believe you will lead a successful career as a physician. 

In order to get a successful committee letter, begin developing a relationship with your premedical advisor as soon as possible. Schedule frequent visits to keep him/her updated on your academic progress and future goals. Also, don’t forget to build relationships with faculty and professors, as they will be the ones writing the bulk of the committee letter. 

Not every college and university offers committee letters. To learn more about your options at your specific institution, contact your premedical advisor. 

Letter packet

Letter packets are often confused with committee letters. However, there are notable differences between the two.  A letter packet, or evaluation packet, is made up of letters from your professors over the years that are stored by your university’s career center. The major difference between the two is a letter packet will not include an evaluation letter from your premedical advising center.

Similar to committee letters, not every college or university offers letter packet services. To learn more about the options at your specific institution, get in touch with the prehealth advisor. 

Keep in mind, the type of LORs you should send with your application depends on each medical school’s specific admissions requirements. For instance, some medical schools require letters from previous professors while other schools have less preference. Demonstrating you can follow directions in medical school applications is very important to medical schools. Therefore, make sure to double-check which kinds of letters you need to send.

Who should I ask to write a letter of recommendation for my medical school applications?

Most medical schools are specific about who your LOR writers should be. The most common LORs that are required are the following:

  • 2 letters must be from science professors with whom you have taken a class and received a letter grade.
  • 1 letter must be from a non-science professor or faculty member with whom you have taken a class and received a grade.
  • Two other recommendations from extracurricular observers

Who qualifies as a science professor and non-science professor?

Most medical schools consider biology, chemistry or physics professors as science professors. Professors outside of these disciplines are considered non-science professors. While some medical schools might accept a science letter from a computer science professor, math professor, or engineering professor, other medical schools won’t. 

To ensure you are collecting the right science and non-science professor LORs, go to each medical school’s website and check their criteria.

Who else can write a letter of recommendation?

Aside from professors, medical schools will accept many other types of reference letters. Here are some examples of who you can ask a letter of recommendation from: 

  • Current employers 
  • Past employers 
  • Principal investigators you’ve done research with
  • Physicians you’ve shadowed 
  • Your university’s prehealth advisor
  • Volunteer supervisors 

You should not ask letters of recommendation from: 

  • Friends 
  • Teaching Assistants 
  • Tutors 
  • Professors or employers you had a relationship with more than five years ago

A good rule of thumb is to request a letter of recommendation from a supervisor of an extracurricular activity you designated as a “Most Meaningful Experience” in your AMCAS application. 

Always remember to prioritize letter writers with whom you have honest and strong relationships, who entirely support your path to medical school, and who can vouch for your academics, leadership, and professionalism.

If I have been out of school for a while, who can I ask to write a letter of recommendation for my medical school applications?

Everyone has their own path to medical school. If your journey means you’ve been out of school for a while and you do not have a relationship with science/non-science professors to write you reference letters, we recommend you try connecting with old professors in person or you enroll in a few local classes to build relationships with some professors.

Do I need a letter of recommendation from a D.O. physician to apply to osteopathic medical schools?

Yes. In order to apply to osteopathic medical schools, you must have a letter of recommendation from a D.O. physician you’ve shadowed. 

D.O. programs acknowledge that most applicants would choose to attend an M.D. medical school, if given the choice. Therefore, D.O. programs like to see candidates who have expressed particular interest in osteopathic medicine.

[Further reading: How to gain shadowing experience as a premed]

When should I ask for a letter of recommendation?

During your undergraduate career, you have the opportunity to build dynamic relationships with professors. Maintaining those relationships over the years, however, is not easy. For example, let’s say you took the same general chemistry courses with the same professor, attended office hours, and earned high grades in each class. Should you wait till you apply to medical school to ask for a letter of recommendation? You can, but chances are the professor will forget who you are, how often you attended class, etc.

If you wait to ask for a letter of recommendation till you need it, your letter might not be as strong as asking immediately after your final class with the professor. Therefore, our recommendation is to request and store reference letters throughout your premedical career using your university’s career center letter storage system or a third-party reference letter storage system. We discuss both of these options more in-depth below. 

If you are beginning to collect letters of recommendation during the year you are applying to medical school, ask your letter writers two months before you would like your letters due. Since most of your writers will be professors, researchers, or health care professionals, they will significantly appreciate a long runway to write a letter for you. In some cases, 2-4 week’s notice will suffice, but our recommendation is two months. Throughout this process, check-in and send friendly reminders of the upcoming deadline. 

How do I ask for a letter of recommendation?

Once you have identified your letter writers, begin by asking them for a meeting to discuss your medical school application. If no other students are present, you can also ask during their open office hours. Always prioritize asking for a letter of recommendation in person. 

Explicitly ask if they are able to write you a strong and personalized letter. By asking this, you will obtain more information about whether or not you should continue to add them to your application. If they tell you that they are not able to write a strong letter, it is recommended that you do not include their letter with your application. Having an impersonal, generic letter is worse than having no letter at all. 

If you have no choice but to ask for the letter of recommendation over email, here are some templates you can use.

Sample templates to ask for letters of recommendation

Professor

If you are asking for a letter of recommendation from a professor you haven’t seen in a few months or years, reintroduce yourself and remind them of your aspirations before you ask for a letter of recommendation. 

Consider this example: 

Dear Professor __(insert professor name)__,

My name is __(insert your name)__. I took your __(insert class name)__ class in __(insert semester)__. Since then, I have continued to pursue my degree in __(insert degree name)__ and I am preparing to apply to medical school. 

Given that your class has been paramount in my education at __(insert university name)__ and remains one of my favorite classes to date, I wanted to ask if you’d be willing to write me a strong and personalized letter of recommendation? 

I would greatly appreciate having your voice and your support in my medical school applications. Also, I am more than happy to meet with you in-person and provide you with more in depth information about me to help you write the letter. Thank you for your time and consideration. I look forward to hearing from you. 

If you are asking for a letter of recommendation from a professor whose course you just finished and the professor knows you by name, you don’t need to reintroduce yourself as shown in the example above.

 Consider this template for professors’ whom’s classes you’ve recently finished: 

Dear Professor __(insert professor name here)__,

I really enjoyed your __(insert name of class)__ course this past __(quarter/semester)__. As you know, I am applying to medical school. Since your class is one of my most recent courses to date, I wanted to ask if you’d be willing to write me a strong and personalized letter of recommendation for my medical school applications? 

If you would like more information about my experiences and commitment to medicine, I am happy to meet with you in-person and/or provide you with a copy of my personal statement and CV. Thank you for your time and consideration. I look forward to hearing from you and receiving your support in my application process.

Employer

This sample letter assumes your employer knows you well. If you work at a larger company and your boss does not know you on a first name basis, skip ahead to the next sample letter. 

Dear _________, 

As you know, I have been pursuing my __(insert degree name)__ degree with plans to apply to medical school. Working at your company during my premedical career has been both rewarding and meaningful. Over the years, I have developed invaluable skills here. Given how well you know me, I would like to ask for your support in my medical school applications. Would you be willing to write a strong and personalized letter of recommendation for me? 

I will provide you with all the information you need for this letter. Having your support would mean a lot to me. Thank you for your consideration, I look forward to hearing back from you.

For more weight in the letter, consider asking your supervisor’s boss to co-sign the letter of recommendation. 

If you work at a larger company and do not have a direct relationship with your boss, consider this sample template:

Dear _________, 

My name is __(insert name)__. I have been with your company for __(insert time frame, I.e. 2 years)__. While working at __(insert company name)__, I have also been pursuing a degree in __(insert degree name)__ at __(insert school name)__. Now I am preparing to apply to medical school. 

I am writing to you to ask if you would be willing to write a strong and personalized letter of recommendation for me? I would be happy to meet with you in person and provide more in-depth information about myself and my commitment to medicine. 

Thank you for your time and consideration, I look forward to hearing from you.

Activities director

Dear ________, 

__(Volunteering/Participating)__ at your __(insert organization name)__ has been an invaluable experience for me these __(past few months/past few years)__. Now that I am preparing to apply for medical school, I am collecting letters of recommendation from individuals who know me well and can speak on my professional abilities. With that said, I would like to ask you if you would be willing to write a strong and personalized letter of recommendation for my medical school applications? 

Having your support would mean a lot to me. Thank you for your consideration, I look forward to hearing back from you. 

Primary Investigator

Dear _________, 

Working in your lab and helping you execute studies in __(insert research topic)__ research has been one of the most meaningful experiences I’ve had during my premedical journey. Now that I am preparing to apply to medical school, I am collecting letters of recommendation from people who’ve gotten to know me professionally. Since I’ve learned so many invaluable skills under your guidance, I wanted to ask if you would be willing to write me a strong and personalized letter of recommendation for my medical school applications. 

I would greatly appreciate having your support in this new endeavor. Thank you for your time and consideration, I look forward to hearing back from you.

Tip: If you don’t know your PI well, request a letter from a postdoc you’ve worked closely with and ask your PI to co-sign it.

What do I do after my evaluator agrees to write me a letter of recommendation?

If the evaluator agrees to write you a strong and personalized recommendation, send him/her an email with all the important information he/she needs to successfully complete the task. This email should include your application components such as your personal statement, your transcript, CV, etc. If they ask for other material, provide it as soon as you can. In addition, provide directions from the application service, such as the AMCAS, AACOMAS or TMDSAS, on how the letter of recommendation should be formatted. 

Afterwards, send them a handwritten thank you note, email, or stop by their office in person to thank them personally for their support. Don’t negate the “thank you” step, as this might leave a bitter taste with evaluators. Since your recommenders always have the option to update letters, you want to keep the relationship positive and show gratitude even after they submit their letter of recommendation.

Letter of recommendation requirements for different medical school application services

There are three major medical school application services: the AMCAS, TMDSAS, and AACOMAS. Each medical school application service has their own specific requirements for letters of recommendation. In this section, we will discuss the specific requirements for each application. Keep in mind that in addition to requirements by the application services, medical schools also have their own respective requirements. 

AMCAS Letter of Recommendation Requirements

The AMCAS requires each letter of recommendation submitted has the applicant’s AAMC ID and the AMCAS Letter ID. Although AMCAS does not require letters of recommendation to be on official letterhead, it’s a good idea to ask your evaluators to use one anyway because many medical schools require it. 

Letters of recommendation can be submitted to AMCAS via their AMCAS Letter Writer Application or Interfolio. (Note: TMDSAS also accepts LORs from interfolio.) 

Luckily, your letters of recommendation do not need to be submitted for AMCAS to verify your application. Therefore, you can submit your AMCAS application and your evaluators can send your letters of evaluation at their convenience. 

For more information on AMCAS letter of recommendation guidelines, visit their official website or their FAQ page. 

TMDSAS Letter of Recommendation Requirements

TMDSAS requires all letters of recommendation be written on official letterhead with the applicant’s name, evaluator’s name, evaluators contact information, evaluator’s signature and the date the letter was written. According to TMDSAS, letters of recommendation dated prior to May 1st will be more heavily weighted by admissions committees than letters written later. 

Like AMCAS, your letters of recommendation do not need to be submitted for TMDSAS to verify your application. In other words, you can submit your TMDSAS application and your evaluators can send your letters of evaluation at a later date. 

Letters of recommendation can be submitted to TMDSAS through their TMDSAS Evaluator Portal or Interfolio. 

Unlike AMCAS, TMDSAS only accepts one committee letter of recommendation packet or three individual letters of recommendation. 

For more information on the specific letter of recommendation requirements for TMDSAS, visit their official website

AACOMAS Letter of Recommendation Requirements

At the date of this post, AACOMAS does not list any specific requirements for letters of recommendation submitted to them. 

Evaluators can submit their letters of recommendation through the AACOMAS Letters of Liaison recommender portal. 

For more information on the specific letter of recommendation requirements for AACOMAS, visit their official website

How many letters of recommendation do I need for my medical school applications?

While the US national average is 4 letters, the exact number of LORs highly depends on each medical school and the application service you are using. For example, AMCAS will allow you to upload up to 10 letters of recommendation while AACOMAS only allows you to upload a maximum of six letters of recommendation. On the other hand, TMDSAS allows you to either upload one committee letter or four individual letters of recommendation. 

In addition to these guidelines, each medical school also has their own respective requirements for letters of recommendation. To ensure that your application is complete, check each school’s website so that you can get your letters in order (and on time). Most schools require a minimum of 3 letters and will allow a maximum of 6 letters. 

The most important rule of thumb is to prioritize quality over quantity. You do not need to send the maximum number of LORs. Instead, send only the letters you know will boost your application and that are from mentors who strongly support your journey to medical school.

What do I do if I am asked to write my own letter of recommendation?

While references typically write their own letters of recommendation, it is becoming increasingly popular for busy individuals to ask you to write your first draft. Writing your own letter of recommendation is a great opportunity to ensure you get a steller letter. In order to write your own letter of recommendation, follow these steps: 

Step 1: Make a list of your positive qualities. 

When writing a letter of recommendation, the first step is deciding what you want to recommend. It can be difficult for us to give ourselves compliments. Premeds, especially, are known to sell themselves short. To ensure you are writing a quality letter, make a list of your positive attributes. These qualities can be related to your character, professionalism, or work ethic. Some examples include honest, punctual, hard-working, helpful, curious, and efficient. 

Step 2: Make a list of specific areas you grew and developed under your mentor’s guidance. 

Medical schools like candidates who have the capability to grow and adapt. Therefore, sharing areas in which you specifically honed your skills will show medical schools you can learn lessons beyond the classroom. For example, if you are drafting a letter of recommendation from a past employer, commenting on improved communication skills would be a good idea. 

Step 3: Write down the duration of time and the capacity in which your recommender knew you.  

How long has the recommender known you for? A few days, months, or years? In what capacity did the recommender know you? Were you a student in his/her class, did you attend office hours or enroll in multiple classes with this recommender? Did you work in this recommender’s lab or volunteer your time to help him or her? All of these details will be taken into account by the medical school. 

Step 4: Draft your letter using the correct voice. 

Remember, this letter is supposed to be written by the evaluator. Therefore, you must refer to yourself in the third person. 

Can I send specific letters of recommendation to specific medical schools?

Depending on your premedical journey, you may find yourself wanting to send specific letters of recommendation to specific medical schools. For example, let’s say you did a summer internship at Stanford University and one of your recommenders wrote a letter specific to Stanford’s medical school. You might not necessarily want this letter to be received by other medical schools, as it would give away your strong preference for Stanford. 

So can you send specific letters of recommendation to specific medical schools? The answer is yes (most of the time). 

If you are using AMCAS for your primary medical school applications, AMCAS allows you to choose which medical schools receive which letters of recommendation. On the other hand, TMDSAS and AACOMAS does not offer this luxury. That means all the letters uploaded to TMDSAS or AACOMAS will be sent to each medical school you apply to through their platform. Therefore, if you are applying to D.O. medical schools or Texas medical schools that use TMDSAS, ask your evaluator to write a general letter of recommendation that is not school-specific. 

Should I waive my right to read my letters of recommendation?

Yes! When the time comes to submit LORs, you will be asked if you would like to waive your right to view them. DO waive your right. By doing so, you will allow your letter writers to be completely transparent and honest with admission committees about their evaluation of you.

If they are notified that you will be viewing the letter they submit, letter writers may hold back and not be completely honest. Medical schools will also be notified if you do not waive your right to view the letter. As a result, the letter might not seem objective and honest to admissions committees. 

Can I submit my primary medical school applications before my letters of recommendation are uploaded?

Yes. AMCAS, AACOMAS, and TMDSAS allows you to submit your primary application without your letters of recommendation. That means they will start processing your application and your evaluators can upload your recommendation letters at their convenience. Once your letters are received, they will be added to your medical school applications.  

Do I need to submit new letters of recommendation if I applied to medical school previously?

Yes. If you are reapplying to medical school, you must submit new letters of recommendation. Neither medical schools nor application services keep LORs on file from previous years. If you would like to store LORs for later application cycles, consider interfolio.

Can I reuse previous letters of recommendation if I reapply to medical school?

When reapplying to medical school, you have the option to send the same letters of recommendation. Ideally, your recommenders can revise the letter with updates about your journey to medical school. 

At a minimum, ask your letter writers to update the date the letter was written. 

How can I store my letters of recommendation for future application cycles?

  1. Your university’s prehealth advising center 

Most universities offer a service in which you can store letters of recommendation that you collect while you are at their university. For more information, contact your university’s prehealth advisor and/or career center. Storing letters of recommendation at your university can also help your prehealth advisor construct your letter packet or committee letter when you apply to medical school. 

  1. Interfolio 

If you are planning to take some gap years in between undergrad and medical school, consider using a third party letter storage system such as interfolio. Letters of recommendation submitted to interfolio are accepted by AMCAS, AACOMAS, and TMDSAS. 

Further reading:

Productive ideas for your gap year(s) 

How to gain trust from faculty and professors 

Download a printable list of M.D. medical schools in the United States 

Download a printable list of D.O. medical schools in the United States

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